Non-typeable haemophilus influenzae-induced exacerbation on a cigarette smoke lung injury model:Protective effect of andrographolide

OBJECTIVE To develop a 2-week cigarette smoke(CS)acute lung injury model exacerbated by haemophilus influenzae(NTHi)and study the protective effect of andrographolide in this COPD model.METHODS Female BALB/c mice,6-8-week-old,were exposed to 4% 3R4 FCS delivered using aperistaltic pump daily for 2 weeks to induce an acute lung injury model.After 2 weeks of smoking,mice were inoculated intratracheally with NTHi to induce exacerbation on the model.Mice were sacrificed 48 h after last bacteria challenge and lung samples were collected for various analyses.RESULTS After developing a 2-week CS acute lung injury model exacerbated by NTHi,the CS+NTHi group was shown to have a higher inflammatory response,higher bacterial clearance,an upregulation of MMP12 mRNA levels and decrease in TIMP1 mRNA levels in the lungs.Administration of Andrographolide suppressed BALF lung cellular infiltrates,TNF-α,CXCL1/KC,IL-1βand 8-OHdG protein levels,together with increased HO-1 and GR mRNA levels and decreased MMP-8 and MMP-9 mRNA levels.Andrographolide was able to ameliorate lung histopathology as observed with H&E staining and inflammation scoring.Andrographolide was also shown to reduce Keap-1 level in lungs without affecting DJ-1 level.CONCLUSION This study demonstrates the protective effect of andrographolide in a novel 2-week CS acute lung injury model exacerbated by NTHi and presents it as a potential therapeutic for COPD.

Can non-typeable Haemophilus influenzae carriage surveillance data infer antimicrobial resistance associated with otitis media?

Importance:In remote communities of the Northern Territory,Australia,children experience high rates of otitis media(OM),commonly caused by non-typeable Haemophilus influenzae(NTHi).Few data exist on antibiotic susceptibility of NTHi from OM.Objective:To determine whether population-level nasopharyngeal NTHi antibiotic susceptibility data could inform antibiotic treatment for OM.Methods:NTHi isolates(n=92)collected from ear discharge between 2003 and 2013 were selected to time-and age-match NTHi isolates from the nasopharyngeal carriage(n=95).Antimicrobial susceptibility were tested.Phylogenomic trees and a genome-wide association study(GWAS)were performed to determine the similarity of nasopharyngeal and ear isolates at a population level.Results:Among 174 NTHi isolates available for antimicrobial susceptibility testing,10.3%(18/174)were resistant to ampicillin and 9.2%(16/174)were resistant to trimethoprim-sulfamethoxazole.Small numbers of isolates(≤3)were resistant to tetracycline,chloramphenicol,or amoxicillin-clavulanic acid.There was no statistical difference in the proportion of ampicillin-resistant(P=0.11)or trimethoprim-sulfamethoxazole-resistant isolates(P=0.70)between ear discharge and nasopharynx-derived NTHi isolates.Three multi-drug resistant NTHi isolates were identified.Phylogenomic trees showed no clustering of 187 Haemophilus influenzae isolates based on anatomical niche(nasopharynx or ear discharge),and no genetic variations that distinguished NTHi derived from ear discharge and nasopharyngeal carriage were evident in the GWAS.Interpretation:In this population-level study,nasopharyngeal and ear discharge isolates did not represent distinct microbial populations.These results support tracking of population-level nasopharyngeal NTHi antibiotic resistance patterns to inform clinical management of OM in this population.

A Rare Case of Aortic Valve Endocarditis and Acute Meningitis Due to Haemophilus influenzae

HACEK organisms represent a rare but important group of causative pathogens in endocarditis. These bacteria have historically been associated with culture-negative endocarditis;however, modern laboratory techniques have made this less common. In this case, we present a 74-year-old man who presented with acute onset altered mentation, fever, and sepsis. He was ultimately found to have Haemophilus influenzae meningitis, cerebral empyema, aortic valve endocarditis, psoas myositis, and L2 - L3 diskitis with osteomyelitis. Although HACEK organisms are commonly found in the oropharynx and upper respiratory tract in humans, our patient did not report recent preceding dental or ENT procedures. H. influenzae is responsible for approximately 0.16% of all cases of bacterial endocarditis, representing a very limited subset. Although generally considered low virulent pathogens, this case demonstrates the unusual extent of infection from a HACEK organism, H. influenzae, causing aortic valve endocarditis as well as atypical non-cardiac sequelae, including acute meningitis.

In vitro interference of cefotaxime at subinhibitory concentrations on biofilm formation by nontypeable Haemophilus influenzae

Objective:To investigate the in vitro interference of cefotaxime at subinhibitory concentrations [sub-minimal inhibitory concentrations(MIC)] on biofilm formation by nontypeable Haemophilus influenzae(NTHi).Methods:The interference of subinhibitory concentrations of cefotaxime on biofilm formation of the clinical strong-biofilm forming isolates of NTHi was evaluated by a microtiter plate biofilm formation assay.The effect of sub-MIC cefotaxime on bacterial cell-surface hydrophobicity was determined using a standard microbial adhesion to n-hexadecane test.Additionally,the effects on bacterial adherence to human fibronectin and expression of bacterial adhesins were also investigated.Results:Subinhibitory concentrations of cefotaxime,both at 0.1× and 0.5× MIC levels,efficiently reduced the NTHi biofilm formation,and this effect was independent of decreasing bacterial viability.Sub-MIC cefotaxime also decreased bacterial cell-surface hydrophobicity and reduced adherence to human fibronectin.Inhibition in the P2 and P6 gene expressions upon exposure to sub-MIC cefotaxime was also noted.Conclusions:Taken together,our results indicate that sub-MIC cefotaxime interferes with the formation of NTHi biofilm,and this effect is feasibly related to the interference with cell-surface hydrophobicity,fibronectin-binding activity as well as alteration of the P2 and P6 gene expression.The findings of the present study therefore provide a rationale for the use of subinhibitory concentrations of cefotaxime for treatment of NTHi-related diseases.

Studies of β-lactamase production in ampicillin resistant Haemophilus influenzae

Objective:To study the molecular mechanisms of β-lactamase production in ampicillin resistant(AmP ) Hae- mophilus influenzae(HI). Methods: Identified the β-lactamases production strain from AmP HI was isolated from clinical cases with K-B method. β-lactamase encoding gene in enzyme production strains were detected by PCR with lactamase gene specific primers, and both plasmid and chromosomal DNA samples. Results: Thirty-two out of 36 (88 .9% ) were found to be β-lactamase production. Twenty-nine out of 32 enzyme production stain were PCR positive (the ratio of PCR positives 90.6% ). There were 25 stains amplified with plasmid DNA positively, and 4 with chromosomal DNA. Conclusion: (l ) Most of the AmPr HI strain produce lactamase is mediated by plasmid. (2) Detection of lactamase encoding gene in HI is a simple and efficient approach to study the molecular basis of ampicillin resistance.

Clinical Characteristics of Haemophilus influenzae at General Hospital in the Central Region of Japan

Haemophilus influenzae is an important pathogen that caused several infection diseases, such as sinusitis, otitis media, sepsis, and meningitis. This study was conducted to find out the prevalence and antimicrobial susceptibility pattern of Haemophilus influenzae isolates at general hospital in the central region of Japan from December 2015 to January 2016. Haemophilus influenzae was identified by standard laboratory procedure. Antimicrobial susceptibility testing was performed by micro dilution assay according to CLSI recommendation. One hundred ninety-one Haemophilus influenzae were isolated, among which 95 (49.7%) were from male and 96 (50.3%) were from female. The age incidence of (0) years, (≤2) years, (≤5) years, and (6≤) years groups were 22(11.5%), 92(48.2%), 61(31.9%), and 16(8.4%), respectively. Positive samples were received mostly from the nasal discharge (177/92.7%), sputum (6/3.1%), tonsillar (6/3.1%), and pharynx (2/1.0%). Ceftriaxone was the most active antibiotics with 100% susceptible rates, followed by ciprofloxacin (99.5%) and minocycline (99%) in our study. Furthermore, we categorized four patterns: beta lactamase-negative ampicillin-sensitive strain (BLNAS), beta lactamase-negative ampicillin-re- sistant strain (BLNAR), beta lactamase-positive ampicillin resistant strain (BLPAR), and beta lactamase-positive amoxicillin-clavulanic acid-resistant strain (BLPACR) from those ampicillin susceptible results. The numbers of female were significant greater than those of male in BLPAR (p = 0.0336). With respect to antimicrobial susceptible pattern, there was no minocycline and piperacillin resistant strain in both BLNAS and BLNAR (p

Invasive <i>Haemophilus influenzae</i>Type b (Hib) Infections in Children in the Pediatric Department of the University Hospital Gabriel Touré(UH-GT)

Introduction: According to Mali’s National Immunization Center, the Haemophilus influenzae b (Hib) vaccine coverage rate was 90% in 2015. Our work aimed to study invasive bacterial infections due to Haemophilus influenzae type b in children aged 0 - 15 years hospitalized in the pediatrics department of the UH-GT. Method: We carried out a retrospective descriptive study from January 2017 to December 2018 (i.e. 2 years) among children aged 0 - 15 years and hospitalized for Haemophilus influenzae type b infection confirmed by culture (blood culture, Cerebro-spinal Fluid, and pleural and skin fluid). Results: Thirty-three cases of Hib infections were collected giving a frequency of 0.2% and the age group 3 months to 3 years was the most affected (72.73%). Children who received no vaccine accounted for 21.21%. The Cerebro-spinal Fluid culture and other samples (pleural and skin) identified the bacterium in 100% of cases, against 72.72% in the blood culture Meningitis was the most frequent pathology (78.79%) and the lethality was high (21.21%). Conclusion: Despite the introduction of the Hib vaccine in the routine immunization program in Mali, Hib infections remain with a high lethality linked to meningitis.

Safety Observation Study on Haemophilus Influenza Type B Conjugate Vaccines Injected at Different Sites in Chinese Infants

In the present study, the safety of Hoemophilus influenza type b conjugate vaccines inoculated in the upper arm deltoid and vastus lateralis muscle was evaluated. 680 infants aged 2-5 months and 6-12 months were selected to be the research subjects in whom the Hib conjugate vaccines were inoculated by injection in the upper arm deltoid and vastus lateralis muscle, respectively. The safety analysis indicated that there were no statistic differences in the incidence rates of adverse reactions when the Hib conjugate vaccines were inoculated at different sites. So we concluded that the safety of inoculation injection of Hib conjugate vaccines in vastus lateralis muscle was the same as that inoculated in the upper arm deltoid.

Report of Haemophilus Influenzae serotype a intracranial infections in older children

Introduction:Haemophilus influenzae(Hi)is subdivided into typeable(a-f)and non-typeable groups.Hi serotype b(Hib)has historically been one of the important pathogens responsible for invasive infection.However,after widespread Hib vaccination,the emergence of other Hi serotypes,specifically Hi serotype a(Hia),was noted during the last few decades,mostly in children younger than 5 years of age.Case presentation:We present two cases of severe intracranial infections with detected Hia in patients>5 years of age within a short time frame and within the same geographic area.Conclusion:Epidemiological studies and surveillance on Hia-related illnesses in all age groups worldwide are needed to better understand the clinical and epidemiological characteristics of Hia.This can establish a platform to develop a candidate vaccine against Hia that might protect children of all ages.

儿童侵袭性流感嗜血杆菌感染的临床特征及血清学分型

目的分析儿童侵袭性流感嗜血杆菌(Hin)感染的临床特征及血清分型特点。方法回顾性分析2015—2021年山西省儿童医院收治的34例侵袭性Hin感染患儿的病例资料。根据临床诊断分为脑膜炎感染组和非脑膜炎感染组。分析患儿的一般资料、症状、体征、实验室血清学指标、Hin血清分型特点及两组间炎症因子水平的差异。结果34例患儿中男22例,女12例,男女比例为1.83∶1,≤36个月患儿占82.35%。脑膜炎感染组患儿降钙素原(PCT)为[23.71(4.10,77.80)]ng/mL、C反应蛋白(CRP)为[200.00(164.55,200.00)]mg/L,均高于非脑膜炎组[分别为1.08(0.49,6.00)ng/mL、69.46(48.09,125.63)mg/L],差异均具有统计学意义(均P<0.05)。血小板计数(PLT)非脑膜炎组[(312.56±186.81)×10^(9)/L]高于脑膜炎组[(183.28±165.67)×10^(9)/L],差异有统计学意义(P<0.05)。白细胞计数(WBC)和中性粒细胞百分比(NEUT)两组间比较,差异无统计学意义(均P>0.05)。分离的Hin菌株中,b型流感嗜血杆菌(Hib)27株,e型2株,f型2株,3株不可分型,未发现a、c、d血清型菌株。脑膜炎感染组与非脑膜炎感染组患儿可分型Hin菌株分布比较,差异无统计学意义(χ^(2)=0.25,P>0.05)。可分型Hin菌株在男、女患儿中的构成比(67.74%VS 32.26%)比较,差异无统计学意义(χ^(2)=1.42,P>0.05)。结论侵袭性Hin感染病例以3岁以内儿童居多,分离株以b型占优势,感染患儿CRP、PCT明显升高,PLT明显低于非感染患儿,对临床诊断有一定应用价值,可结合临床及其他检验项目为侵袭性感染疾病的早期分类诊断及抗感染治疗提供有效支持。

Treg细胞抑制慢性中耳炎模型小鼠中耳炎症的进展

目的探究慢性中耳炎(chronic otitis media,COM)小鼠中Treg细胞与炎症发展之间的关系。方法采用不可分型流感嗜血杆菌(NTHi)腹腔注射和中耳咽鼓管(ET)阻断的方式诱导构建慢性中耳炎小鼠模型(模型组),选择健康BALB/c小鼠作为对照组。分别在建模后第3,14,28,56天分离收集小鼠中耳积液和中耳黏膜组织,通过苏木精-伊红(HE)染色检测MEM病理变化,采用免疫组织化学染色评估CD4^(+)和Foxp3^(+)T细胞水平,ELISA和Western blot分别检测小鼠中耳积液和中耳黏膜组织中肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-10和转化生长因子(TGF-β)水平,流式细胞术分析CD4^(+)CD25^(+)Foxp3^(+)细胞比例。另取COM模型小鼠分为PBS组和抗-CD25组。抗-CD25组小鼠腹腔注射抗CD25 mAb模拟体内Treg耗竭,PBS组小鼠腹腔注射等量PBS溶液,第56天收集小鼠中耳积液、中耳黏膜组织、脾脏和颈部淋巴结组织,检测分析脾脏、颈部淋巴结和中耳黏膜组织中CD4^(+)CD25^(+)Foxp3^(+)细胞比例,中耳黏膜组织中炎性因子水平,以及中耳积液中细菌水平。结果HE结果显示,对照组小鼠中耳黏膜组织正常,模型组小鼠中耳黏膜组织出现炎性细胞浸润,细菌数量、炎性细胞数量和黏膜厚度均增加(P<0.05)。与对照组比较,模型组小鼠中耳黏膜组织中CD4^(+)CD25^(+)Foxp3^(+)细胞比例升高(P<0.05),中耳积液和中耳黏膜组织中炎性因子IL-1β、TNF-α、IL-10和TGF-β的水平均升高(P<0.01)。与PBS组比较,抗-CD25组小鼠中耳黏膜组织、脾脏和颈部淋巴结组织中CD4^(+)CD25^(+)Foxp3^(+)细胞比例均降低(P<0.05),中耳积液中细菌数和中耳黏膜组织中炎性因子IL-1β、TNF-α、IL-10和TGF-β的水平均降低(P<0.01)。结论Treg细胞在慢性中耳炎的炎症平衡维持中具有重要作用,抑制炎症的进展,但过度的Treg细胞抑制了宿主对细菌的清除作用。

冻干b型流感嗜血杆菌结合物疫苗中磷含量测定方法建立及验证

目的:建立冻干b型流感嗜血杆菌(Hib)结合疫苗磷含量检测的超滤法联合紫外分光光度法,并对该方法进行验证及初步应用。方法:用去离子水将样品溶解后超滤,收集超滤管中Hib多糖,采用等体积比硫酸高氯酸消解样品,使用钼酸铵在酸性条件下与磷形成磷钼酸,与维生素C生成蓝色化合物,在825 nm下有最大吸收。对该方法进行线性、精密度、稳定性、准确度验证。用建立的方法检测3批次商业化冻干Hib结合疫苗磷含量。结果:标准磷在质量浓度1~10μg·mL^(-1)内线性关系良好(r=1.000),线性方程为Y=8.878×10^(-2)X+2.402×10^(-3),方法在低、中、高浓度水平下回收率均值分别为在97.35%、96.65%、97.42%(n=3),RSD分别为2.55%、0.95%、0.95%;重现性试验的RSD为2.81%;中间精密度RSD 2.14%;磷标准品衍生物溶液室温放置1 h稳定,RSD为0.39%。结论:该方法结果准确、可靠,可用于冻干b型流感嗜血杆菌结合疫苗磷含量检测,同时也为其他多糖蛋白结合疫苗磷含量测定提供了思路。

高效阴离子交换色谱-脉冲安培检测法测定吸附无细胞百(三组分)白破灭活脊髓灰质炎和b型流感嗜血杆菌(结合)联合疫苗的多糖含量

目的 采用高效阴离子交换色谱-脉冲安培检测法测定吸附无细胞百(三组分)白破灭活脊髓灰质炎和b型流感嗜血杆菌(结合)联合疫苗(以下简称DTac P-s IPV-Hib)中多糖含量,并对方法进行验证。方法 在1 ml样品中加入0.02 g柠檬酸钠,振荡混匀后,置于37℃保温24 h,4000×g离心5 min收集上清液,稀释后加入6 mol/L盐酸,100℃下加热2 h,冰浴10 min后加入0.8 ml氢氧化钠(1 mol/L)溶液用于终止酸水解。采用高效阴离子交换色谱-脉冲安培检测法根据检测信号峰面积计算对应水解荚膜多糖(PRP)含量,通过PRP占多糖含量干重的41.3%计算出总的多糖含量。结果 核糖醇参考品浓度在0.1~1.5μg/ml范围内标准曲线r2>0.99,检测下限可达10ng/ml。核糖醇加标回收率均在95%~105%;对高效阴离子交换色谱-脉冲安培检测法检测多糖的重复性和中间精密度进行验证,相对标准偏差(RSD)均小于5%,方法专属性和耐用性良好。结论 使用柠檬酸钠作为解吸附剂,与高效阴离子交换色谱-脉冲安培检测法相结合可用于DTac P-s IPV-Hib中Hib多糖的含量检测,为产品的质量控制和稳定性研究提供参考。

Activity of ciprofloxacin and azithromycin on biofilms produced in vitro by Haemophilus influenzae

Background It is recognized that Haemophilus influenzae isolated from patients with otitis media forms biofilms both in vitro and in vivo, suggesting that biofilm formation in vivo might play an important role in the pathogenesis and chronicity of otitis media, but the effect of antibiotics on biofilm has not been well studied. We investigated the impact of ciprofloxacin and azithromycin on bacterial biofilms formed by Haemophilus influenzae in vitro in this study. Methods Eleven strains of Haemophilus influenzae were isolated from sputum specimens collected from patients with acute exacerbation of chronic obstructive pulmonary diseases. Formation of bacterial biofUm was examined by crystal violet assay and a scanning electron microscope. Alterations of biofilms were measured under varying concentrations of azithromycin and ciprofloxacin. Results Striking differences were observed among strains with regard to the ability to form biofilm. Typical membrane-like structure formed by bacterial cells and extracellular matrix was detected. Initial biofilm synthesis was inhibited by azithromycin and ciprofloxacin at concentrations higher than two-fold minimal inhibitory concentration. Disruption of mature biofilms could be achieved at relatively higher concentration, and ciprofloxacin displayed more powerful activity. Conclusions Haemophilus influenzae is capable of forming biofilm in vitro. Sufficient dosage might control early formation of biofilms. Ciprofloxacin exerts better effects on breakdown of biofilm than azithromycin at conventional concentration in clinics.

Determination of ribose and phosphorus contents in Haemophilus influenzae type b capsular polysaccharide by a quantitative NMR method using a single internal standard

The ribose and phosphorus contents in Haemophilus influenzae type b(Hib)capsular polysaccharide(CPS)are two important chemical indexes for the development and quality control of Hib conjugate vaccine.A quantitative ^(1)H-and ^(31)P-NMR method using a single internal standard was developed for simultaneous determination of ribose and phosphorus contents in Hib CPS.Hexamethylphosphoramide(HMPA)was successfully utilized as an internal standard in quantitative ^(1)H-NMR method for ribose content determination.The ribose and phosphorus contents were found to be affected by the concentration of polysaccharide solution.Thus,15–20 mg·L^(−1) was the optimal concentration range of Hib CPS in D_(2)O solution for determination of ribose and phosphorus contents by this method.The ribose and phosphorus contents obtained by the quantitative NMR were consistent with those obtained by traditional chemical methods.In conclusion,this quantitative ^(1)H-and ^(31)P-NMR method using a single internal standard shows good specificity,accuracy and precision,providing a valuable approach for the quality control of Hib glycoconjugate vaccines.

血流感染患儿流感嗜血杆菌流行特征及耐药性

目的了解儿童血流感染患者中流感嗜血杆菌(haemophilus influenzae,HI)临床分离株的流行特点及耐药性,为HI血流感染的精准诊疗提供科学依据。方法回顾性分析河北省儿童医院3个月~7岁住院患儿血液标本中分离的44株HI的分布和药敏结果。采用VITEK MS进行菌株鉴定,K-B法测定药敏试验,头孢硝噻吩纸片法检测β-内酰胺酶,根据美国临床和实验室标准化协会2020年的标准进行药敏结果判断。结果50%(22/44)HI血流感染患儿为1岁以下婴儿。95.5%(42/44)HI血流感染患儿有明确感染灶,其中72.7%(32/44)单独或合并有肺炎、支气管炎等呼吸道相关疾病,45.5%(20/44)单独或合并有脑膜炎。血流分离的HI中59.1%(26/44)的菌株产β-内酰胺酶;对复方新诺明的耐药率最高(75%),其次为氨苄西林(61.4%),对氯霉素和利福平的耐药率较低(<10%);所有菌株对头孢他啶、头孢吡肟、氨曲南、亚胺培南、美罗培南和环丙沙星敏感。结论儿童HI血流感染好发于1岁以下婴儿,临床表现以肺炎和脑膜炎多见,第三代头孢菌素可作为其经验性治疗的首选药物。

不可分型流感嗜血杆菌生物膜在儿童慢性肺部感染中的作用

目的探讨不可分型流感嗜血杆菌生物膜在儿童慢性肺部感染中的作用。方法从临床微生物室样本库中选取2019年2月至2021年10月从健康儿童(健康对照组)鼻咽部和肺部感染儿童(肺部感染组)肺泡灌洗液中分离培养的流感嗜血杆菌,比较健康儿童与急性和慢性肺部感染患儿分离菌株体外生物膜在不同时间点的生成情况。结果选取流感嗜血杆菌89株,其中健康对照组34株,慢性肺部感染组30株,急性肺部感染组25株。所有菌株通过聚合酶链反应对荚膜基因bexA的检测发现,均为不可分型流感嗜血杆菌。急性和慢性肺部感染组在不同时间点(第1、2、3、4、7天)之间的吸光度差异有统计学意义,慢性感染组在第4天的吸光度最高。第4天健康对照组、急性和慢性肺部感染组之间的吸光度差异有统计学意义(P<0.05),慢性肺部感染组吸光度高于健康对照组和急性肺部感染组,差异有统计学意义(P<0.05)。结论不可分型流感嗜血杆菌生物膜的生成需要较长时间,在慢性肺部感染患儿中生成能力高于急性肺部感染患儿和健康对照儿童。

赣州市呼吸道伴发热症状病例的多病原研究

目的探讨赣州市呼吸道伴发热症状病例的病原阳性检出情况及病原特点。方法选取2021年1月至2022年3月赣州市疾病预防控制中心收集的198例不明原因呼吸道伴发热症状患者的咽拭子样本进行研究。采用基于微流体芯片(TAC)的核酸快速检测技术进行病原体检测,记录阳性检出率以及病原类型,分析病原分布特点。结果在198例患者中,0~<6岁人群的阳性检出率高于6~<18、18~<46、46~65岁人群,年龄>65岁人群的阳性检出率高于6~<18岁人群,差异有统计学意义(P<0.005)。本次共检出14种病毒以及7种细菌,主要病原类型为流感嗜血杆菌、人类疱疹病毒4型(HHV-4)、肺炎克雷伯菌、腮腺炎病毒、乙型流感病毒。在各年龄段人群中,0~<6岁人群的HHV-4、流感嗜血杆菌阳性检出率较高,>65岁人群的肺炎克雷伯菌、乙型流感病毒阳性检出率较高,6~<47岁人群的腮腺炎病毒阳性检出率较高。不同年龄段的主要病原类型分布阳性检出率比较,差异有统计学意义(P<0.05)。在198例患者中,体温正常95例,低热61例,中度发热20例,高热22例。中度发热、高热人群的主要病原阳性检出率高于正常、低热人群,差异有统计学意义(P<0.008)。结论赣州市呼吸道伴发热症状者的病毒/细菌阳性检出率以婴幼儿和老年人居多,不同年龄段人群的病原分布存在差异,且体温与阳性检出率有关。

2017-2019年山东省临床分离流感嗜血杆菌的耐药性监测

目的 分析山东地区临床分离流感嗜血杆菌的菌株分布特点及耐药性,促进临床对流感嗜血杆菌治疗药物的合理选择。方法 依托山东省儿童细菌&真菌耐药监测研究协作网,收集2017年1月1日—2019年12月31日山东省医疗单位临床分离的非重复流感嗜血杆菌,采用纸片扩散法或自动化仪器法按统一方案进行药敏试验,结果判读依照CLSI2022版M100抗微生物药物敏感性试验执行标准。使用WHONET 5.6和SPSS 22.0软件对数据进行分析。结果 共收集流感嗜血杆菌18 057株,多分离于痰、咽拭子、肺泡灌洗液等标本,感染呈季节性分布。2017—2019年氨苄西林耐药率为69.5%、76.4%、79.7%,β内酰胺酶阳性率为63.0%、72.1%、76.6%,β内酰胺酶阴性氨苄西林耐药的流感嗜血杆菌(BLNAR)占比分别为9.7%、7.9%、7.3%。对氨苄西林、氨苄西林-舒巴坦、头孢呋辛耐药率均呈逐年上升趋势,对氯霉素、亚胺培南、美罗培南、左氧氟沙星的耐药率均呈现逐年下降的趋势。结论 山东省流感嗜血杆菌对氨苄西林的耐药率>60%,BLNAR的均值高达8.1%,据此氨苄西林不宜为治疗流感嗜血杆菌的临床首选药物;对第三代头孢菌素的耐药率低,宜作为流感嗜血杆菌治疗的首选药物。该菌对临床儿童常用抗生素耐药形势严峻,亟需加强其耐药监测,从而指导临床合理使用抗菌药物以减缓流感嗜血杆菌的耐药。

某医院流感嗜血杆菌的耐药性及分子流行病学特征

目的 探讨本院流感嗜血杆菌(HI)的耐药性、血清型分型和多位点序列分型(MLST),为指导临床合理用药提供依据。方法 收集2019年1至5月泰安市中心医院临床分离30株HI,采用纸片扩散法检测其对抗菌药物的敏感性,采用玻片凝集法进行血清学分型,头孢硝噻吩纸片法检测细菌β-内酰胺酶表型,PCR扩增耐药基因,MLST鉴定菌株之间的亲缘关系。结果 30株细菌血清型均为不定型(NTHI),对氨苄西林、复方新诺明和头孢呋辛耐药率分别为70.00%、70.00%和46.67%,阿奇霉素的非敏感率为36.67%,对其他抗菌药物敏感性高。70.00%(21/30)菌株检测到β-内酰胺酶基因,与表型一致,基因型均为TEM-1型,未检测到ROB-1型。MLST结果显示30株细菌共检出18种ST型,ST12型检出率最高。结论 本院分离HI对氨苄西林和复方新诺明呈现出严重耐药性,三代头孢菌素和β内酰胺酶抑制剂可作为临床治疗的首选药物。β-内酰胺酶基因分型均为TEM-1型且菌株以散发为主。